Accomplishing this in the midst of a nasty and deep national recession may prove to be difficult if not impossible, but it appears Congress is going to move ahead and give it a try in the next few months.

Wednesday, May 13, 2009

Medicare has decided not to pay for virtual CT colonoscopies.Medicare does cover regular invasive colonoscopies.The x-ray procedure is a substitute for invasive colonoscopies. It is cheaper and non-invasive, but does involve x-ray radiation.The invasive colonoscopy allows the surgeons to excise any pre-cancerous polyps found, saving a second procedure.If the CT colonoscopy finds pre-cancerous growths, then a regular colo must be done to excise the polyps, thus causing two procedures instead of one.Medicare does point out that the Medicare population, almost all of whom are 65 and over, may not be a good indicator for the under-65 population. Medicare is willing to look at future data.These are the sorts of dilemmas health insurers must wrestle with. No decision will make everyone happy.Rationing or evidenced-based medicine? Depends on your point of view.

Senators weigh tax hikes to pay for health care

WASHINGTON – Senators are considering limiting — but not eliminating — the tax-free status of employer-provided health benefits to help pay for President Barack Obama's plan to provide coverage to 50 million uninsured Americans.

Finance Committee ChairmanMax Baucus, D-Mont., said Tuesday that there are no easy options. Senators began grappling with how to finance guaranteed coverage, a cornerstone of Obama's plan to overhaul the health care system. Independent experts put the costs at about $1.5 trillion over 10 years......

Saturday, May 9, 2009

Employer-paid health insurance is usually a non-taxable benefit to the employee. IRC S106.

Over the years this “loophole” has popped up in various discussions of tax fairness and expanding health care coverage.

The Obama administration has floated various trial balloons, and Senator Baucus (D. Montana), an influential player in the health care reform debate, thinks the time for change may have come.

Rep. Charles Rangel (D. New York) a veteran representative and powerful chairman of the House Ways and Means Committee says simply, “no way.” All tax legislation originates in Ways and Means.

Candidate Obama criticized John McCain for proposing the taxation of health insurance benefits, but advisors to President Obama will not close the door, including new DHHS secretary Sebelius.

President Obama needs a major funding source to help close the deficit and to provide a $600M plus health care reserve fund.

Some labor unions fiercely defend the tax break, as middle class union members would be hit hard by a tax on health insurance benefits.

(Using real tax family returns and creating pro formas by adding policy amounts, the tax increase could range from about $1500 - $5000, depending on the structure of the tax, the possible applicability of FICA and Medicare taxes, and the taxation policies of state and local governments.)

In theory, employers would save some money because enhanced government programs would slow or eliminate “cost shifting” from the uninsured to the insured. However, employers might end up paying higher matching FICA taxes. Employees would be unlikely to see any of the savings (if any).